NA and MAT... Friends, enemies or case-specific?

Are 12-step groups like NA and MAT modalities exclusive of each other?

A physician who practices in MAT modalities recently made a blog entry about 12-step groups on which there was much passionate debate in the comments where a strong majority of MAT patients and advocates made the case that any mutual exclusivity between NA and MAT has been created by the rejection, scorn and judgement that many NA groups have shown towards patients whose recovery has been successful in large part because of their being patients in MAT programs. This physician seemed to defend the 12-step groups and try to say that the MAT patients were being critical and even compared many of us to the very folks who say that methadone doesn't work and is poison - without any evidence to support their argument. 

It is hard for me to comprehend that a physician who treats MAT patients on a daily basis in both OTP and OBOT settings could be so "caught off guard" by the passionate opposition to MAT patients' involvement in 12-step groups that many patients and advocates expressed.  I have personally known multiple patients, from all across the country (and the world), who have experienced similar rejection and accusations of "not being clean" due to their employing the use of maintenance medications in their recovery... And those stories, from wide and far, were again described in many of the comments on this blog.  Let me say that I am for ALL treatment modalities, approaches, groups and anything else that offers help and hope, and I believe that ANYTHING that helps people on the road to recovery should be supported to the greatest extent possible.  I personally attended several different NA groups in the hopes of offering and receiving support on the road to recovery before the rejection based solely on the fact that I am a methadone maintenance patient took its toll and led me to conclude that these particular meetings had the potential to do more harm to my recovery than they did the potential to help and aid me in strength along my journey.  A proponent of 12-step groups recently wrote a stigma-filled editorial in my local paper criticizing methadone and buprenorphine therapies as "trading one set of chains for another" to which I felt compelled to respond with my own letter to the editor.  This editorialist only further gives credence to my conclusions that any mutual exclusivity that exists between NA and MAT has been created by proponents of the 12-step groups themselves - not by MAT patients who have sought out support at these groups with open minds as they searched for tools to aid their recovery journey.  

In reflecting on this issue further I decided the best thing to do was to go to NA World Services themselves with an open mind to find out what THEY say "officially" about the use of maintenance medications in treatment modalities.  I went to the website of NA World Services and found this bulletin (#29) that was drafted by the Narcotics Anonymous World Services Board of Trustees titled Regarding Methadone and other Drug Replacement Programs which says, in part:

"Members on drug replacement programs such as methadone are encouraged to attend NA meetings. But, this raises the question: "Does NA have the right to limit members participation in meetings?" We believe so. While some groups choose to allow such members to share, it is also a common practice for NA groups to encourage these members (or any other addict who is still using), to participate only by listening and by talking with members after the meeting or during the break. This is not meant to alienate or embarrass; this is meant only to preserve an atmosphere of recovery in our meetings."

This makes it clear that those at the "top" of the NA organization believe that those in medication-assisted treatment programs ("replacement therapy") are "still using," that they do not want MAT patients to share at group meetings, and also suggests that if MAT patients do share they would damage the "atmosphere of recovery" at the meetings. Could it be anymore clear?

What do YOU think? As for me, I rest my case.



  1. NUMBER ONE: Uh oh my reply is too dang long and no I am not going to make it short lol. It will be a series of replies. I am hoping the order will be downward but I will number them just in case. I was one of those MAT patients that took offense to the idea that NA should be incorporated into our MAT Recovery. Was it said she forced her patients? No. Did she say it should be mandatory? No. But that was all of her defense in the end. She never tried to force her patients or us to agree and that was about all she had to say at all in responses to the replies she got.

  2. NUMBER TWO: Well I was one if those MAT patients that took offense to the ideation that NA should be incorporated into our MAT Recovery Process. Was it said she forced her patients? No. Did she say it should be mandatory? No. That was her defense in the end...She never tried to force her patients or us to agree and that was about all she had to say at all in responses to the replies she got. After starting the first blog out with 25 (plus or minus) reasons she has heard why MAT Patients do not attend NA meetings, (some were reasonable reasons and some that were ridiculous and some were isolated incidents surely) it was evident her disdain towards patients who don’t attend NA when she got to her last one, and I quote .... "And…my all-time favorite: I don’t want to get addicted to meetings. I just love that excuse…you may be snorting dangerous pills, alienated your friends and family, be nearing financial ruin, but none of that bothers you as much as the possibility you may get addicted to going to recovery meetings." and what? We were not supposed to feel offended??...I WAS

  3. NUMBER THREE: Even if she would have ended the blog right there, but she didn't she further went into 3 more blogs the second being a shame on us for not agreeing and being bitter...going into this long rant, praising her suboxone patients because they are much more comfortable in their treatment than methadone patients, and I quote "I’m starting to realize that these patients may be rare. They’re comfortable with being on Suboxone and equally comfortable going to and participating in 12-step meetings. I enjoy them very much, and they’re easy to treat, since they’ve already had recovery experience." She went on to a third blog about how she was surprised that MAT patients did not realize that NA has a specific way to run their meetings and if we share our story it is distracting to their purpose in fact she says and I quote, "Overall, the mood of 12-step meetings is one of humbleness, where one recovering addict shares what worked for her with the rest of the group, without expectations and with humility." And yet she says it is not important for us to share what worked for us??? Because if we did share it then it would be medication worked for us right??? But in her responses to us she told us several times over....it was not necessary to even mention being on medicine...well to be exact let me quote this one too "Reading the replies, it’s clear MAT patients feel they must share about their medications. I don’t understand that. Diabetics don’t share about their insulin dose. Those on antidepressants don’t share about their meds, nor do people with other diseases. I don’t get why you feel you are lying if you don’t share about methadone/buprenorphine. Of course you’ll get some knuckle -headed responses if you share about methadone or buprenorphine. I still don’t get why it’s necessary” Well please let me answer that one. Diabetics don’t share their insulin status because they are not there for eating too many donuts or ice cream not this meeting they are there to discuss their addiction and what helps in their addiction? MAT Does. (No harm meant to any diabetics I assure you.)

  4. NUMBER FOUR: On to a fourth blog about "Moving On" explaining that she had went thru her previous blogs and deleted posts/replies that were derogatory and she said people had been attacking and insulting even about our own medication assisted modality....Now I might admit I did tell how NA had treated MAT all those years I was a member, but I promise you...I did not nor any MAT poster on that or any blog say anything attacking or bad about our modality she might have mistook comments about staff same such as she....that force their views and ideas on patients and punish us for not complying but attack MAT??? No. Hell No. But anyways she ended this (one short paragraph) blog after shaming us with and I quote "I want my site to be about solutions, working together, positive ideas, and not an endless bitch session." So unless you say what seems always in agreement and positive you will be deleted. That last sentence is my remark not her quote. And well, somewhere in the midst of these blogs she was trying to convey that NA members have changed their view and are playing nice at meetings now with MAT Patients. (As long as we keep our dirty little secret to ourselves). In all actuality regarding all the blogs I saw very little opposition to the NA Modality from the MAT responders. We were really all just saying that it is no place for MAT Patients to have to or to subject themselves to for many apparent reasons let alone not suffer the ridicule.. We were only in deep opposition regarding when it was expected or even necessary for someone on medication assisted treatment to attend these meetings. Many of us agreed it to be a place others might find quite helpful with other addiction needs...I know I did for sure.

  5. NUMBER FIVE: Her ideas that NA will play nice and allows MAT patients to be involved is wrong and I only live a 100 or so miles from her area in NC, so I happen to know this to be true. I have attended and drove many addicts (of the non opioid choice) to meetings over the last 10 years attended many myself (prior to MAT) as I don't know of any other place to take someone addicted to alcohol or cocaine and I help all addicts not just opioid. I have been an “ANTI- MAT” advocate at them myself (and for that I am sorry) and then I have been a victim at them personally. I regret both positions as maybe I would have given MAT a try a long time ago had I not listened and participated in their views on MAT. The very thing and the only thing that has helped me, saved me, saved my family, improved my life and made me happy. I can’t be a part of anything that would find fault in my doing what works and what has worked for me and worked for many way before me and many way after me. But Hey in all actuality because we gave her the ANOTHER EXCUSE of why we (MAT Patients) don't attend NA we are now deleted and left unheard. I take it she didn't like our excuse that we do not need NA for recovery and actually it goes against and shames all we know to be our recovery. I wonder if this will become her FAVORITE ONE (excuse) now.

  6. I hope you do not regret asking us (me) to chime in....

    1. @wayovermyhead - I most certainly do not regret asking for patients and advocates to chime in on this discussion! :-) Your post could have required 20, 40 or even 50 comment spaces in order to fit it all in, and I would have been equally glad that you shared (as I am now). I certainly understand (and appreciate) your passion primarily for two reasons:

      1) "I have attended and drove many addicts (of the non opioid choice) to meetings over the last 10 years attended many myself (prior to MAT) as I don't know of any other place to take someone addicted to alcohol or cocaine and I help all addicts not just opioid. I have been an “ANTI- MAT” advocate at them myself (and for that I am sorry)..."
      2) "...and then I have been a victim at them personally."

      Your situation and experiences are extremely unique AND uniquely relevant to this discussion because of your 30(ish) years of involvement in 12-step-based groups and organizations prior to your becoming (to what was, no doubt, a welcomed relief to have found a modality that worked more effectively in treating your addictive disorder than all those previous 30+/- years combined) a MAT patient and advocate yourself. You know first hand, with around three decades of personal experiences from 12-step meetings around the country, about those things of which you speak. You, like me, were even an anti-MAT "advocate" prior to personally discovering MAT's life-saving and life-restoring possibilities. Then, also with experiences similar to my own, you also had the same experiences once the "tables were turned" and you became one of the MAT patients you had targeted and discriminated against yourself all those years prior. You have felt and experienced what has become the all-too-often "gift" of rejection, judgement and scorn that has been offered a MAT patient from 12-step groups and chairpersons around the world. As such, it was even more dismissive of said doctor (in my humble opinion) to chastise and then delete many of your respectful, but disagreeable, thoughts, comments and reflections because they did not align with his/her own.

      Thank you for sharing @wayovermyhead, and thank you for read the TN director's blog. Your thoughts, comments and input are welcome here ANYtime. I sincerely hope you will visit us and leave your thoughts often - and this is equally my hope for other MAT patients, providers, advocates and allies. This is a safe space for open, uncensored discussion for the MAT community and those who, with a sincere heart and open mind, want to learn more about the most effective modality for treating opioid addiction that is currently available.



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